Anastomotic clamp.



, PATENTBD MAR. 26, 1907. G. F. ROOSEVELT.

No. s48,126.

TH: Nomar: Ps1-:Rs ca, wsmmrraw, nA c.

110.848,126. l PATBNTBD MAR.26',190'1. Y' G.- Pi ROOSEVELT. l

. ANASTOMO'IIG GLAMP'.

APPLIcATIoN rum) JULY 2v. 190e.

2 SHEETS--BHBBT v2.

INVENTOR G.. F' looszvz H' -vv 1 ATTORNEY.

THE NoRRl PETERS co., WASHINGTON, n. 7A

vice; Fig. 2, a side or edge view thereof; Fig.

GILES F. ROOSEVELT, OF DENVER, COLORADO.

ANASTOMOTIC CLAMP.

Specification of Letters Patent.

Patented March 26, 1907.

Application filed July 27,1906. Serial No. 328,036.

To all whom t may concern:

Be it known :that I, GILns F. ROOSEVELT, acitizen of the United Statesof America, residing at Denver, .in the county of Denver and State ofColorado, have invented certain new and useful Improvements inAnastomotic Clamps, of which the following is a specification.

My invention relates to improvements in surgical clamps, and ,moreparticularly in the class of instruments vemployed to retain theportions to be united in anastomotic operations.

The object of the invention is to provide a compound clamp by means ofwhich the parts to be anastomosed are clasped and held in relativeposition during the operation and which thus takes the place of twoseparate clamps heretofore required and o-bviates the presence of anassistant to maintain the clamped portions in the proper relativeyposition. I attain this object by the device illustrated in theaccompanying drawings, in the various views of which like parts aresimilarly designated, and in which- Figure 1 represents a plan view ofthe de- 3, a fra mentary view illustrating a modified form o' theblades; Fig. 4, a cross-section taken along a line 4 4, Fig. 1; Fig. 5,a crosssection taken along a line 5 5, Fig. 1; Fig. 6, a cross-sectiontaken along a line 6 6, Fig. 1, Fig. 7, a perspective view of one of theinterchangeable laterally-movable jaw members; Fig. 8, a perspectiveview of the stationary central jaw member; Fig. 9, a plan view, drawn toa reduced scale, illustrating the application of the rubber sleevesFigs. 10 and 11, views illustrating the manner in which the device isused; and Fig. 12, an enlarged cross-section taken along a line 12 12,Fig, 9.

The instrument, as illustrated in the drawings, comprises a central, inpractice, stationary member 10 and two therewithpivotally-connectedlaterally-movable members 11, which together 'constitute a compound ordouble clamp.

The central member 10 consists of `a rigid bar 12, which in practiceconstitutes the common stationary jaw of the two clamps and whichterminates in an axially-alined shank 13, the outer extremity of whichis provided with a iingerfloop 14.

The exterior movable members 11 of the l device are in a straight-j awedclamp identical and interchangeable andconsist ofaslightlycurvediiexible blade 15 at the end of `an inwardly-bent shank 16, the oppositeextremity of which is, like shank 13, provided with a finger-loop 17 .lThe Shanks of the frnovable members 11 extending in a plane with theedges of the blades, are in practice disposed along opposit'e sides ofthe shank 13 =0'f the stationary member and pivotally connectedtherewith in proximity to their junction with the blades "by means ofalso-called HCollins lock, which permits ready detachment of the outermembers from the central one. The shank 13 of the central memfber 10 hasto this end been provided with the Aout- Wardly-ranging pivot-pins 13,Which in practice protrude through corresponding apertures 19 in theShanks of the movable members and with lugs 20 and 21, Which, extendingfrom opposite edges of the shank in parallel relation thereto, engagethe upper surface of the Shanks 16 when the blades are in the closedposition and permit removal of the members when the latter are turned ataph proximate right angles to the stationary member.

In connection I wish it understood that the lock or joint as describedbeing in com- Vmon use on surgical instruments is not claimed by me asmy invention and that any suitable method may be employed to hinge thetwo movable members of my compound clamp to the stationary portion.

Shank 13 of the stationary member `is furthermore provided in proximityto the fingerloop 14 with two opposite laterally-extending segmental`iarms 22, the opposite faces of which are respectively provided witha-series of ratchet-,teeth with the object to `maintain the movableportions of the instrument in any desired position. Members 11 have tothis end suitably-shaped detents 24, which, extending from one of 'theedges of their Shanks in juxtaposition to their looped extremities,engage the interdental spaces on the segmental arms when the blades arein the closed position. Blades 15 of members 11V are preferably providedwith longitudinally-extending slots 25, which not only increase theflexibility of the blades, but materially lighten the instrument. Therigid jaw 12 is also provided in its opposite faces with recesses 26,which in addition to lesseni-ng IOO the weight increases the holdingqualities of the aw.

To obtain satisfactory results in using my device, the flexible blades15, which, as stated heretofore, normally curve inwardly toward thestationary jaw, should be curved to a degree to compensatefor the usualthickness of the flesh or matter to be held between them and the rigidjaw 12, so that when the portions to be anastomosed are held in theproper relative position the inner surface of the blades will extendparallelly to the epposite faces of the common jaw 12, and the pressureexerted thereby will in consequence be uniform from end to end. Thisfeature is illustrated in Fig'. 1, in which one of the blades is shownin its normal position, while the opposite'one is brought in clampingposition by interposition of a stop A.

To prevent injury to the tissues of the patient and to incidentallyaugment the holding qualities of the clamps, I provide sleeves or tubes27, which, being composed of rubber or other suitable material, may beslipped over the rigid jaws and the movable blades, as illustrated inFigs. 9 and 12. It will be understood that when the sleeves are used thecurvature of the blades 15 may be modified to compensate for thethickness of the rubber, which in practice is added to the thickness ofthe clamped portions. In the modified form illustrated in Fig. 3 thejaws of the clamps are curved insteadv of straight for the purpose ofadapting the instrument to different kinds of operations.

Having thus described the mechanical construction of the device, itsoperation and advantages derived therefrom will be readily understood.

The instrument, as stated above, is practically adapted for. use insuture anastomic work, where it takes the place of the two clampshitherto employed and which, by reason of the difficulty encountered bythe assistant in maintaining the proper relative position of the twoportions to be uni ted, often become a source of annoyance to thesurgeon and frequently lead to actual damage to the tissues. ln additionit should be observed that the use of the two clamps requiring the useof both hands of the assistant prevents his being of service in otherways, whereas my device, resting upon the edge of the incision,maintains unaided the parts in their relative position.

The method of using my device, although varying in accordance withcircumstances, remains in principle the same in all anastomotieoperations. In case of osterior gastrojejunostomy, for example, t iestomach is grasped, as usual, at the desired angle between one of theblades 15 and the aw 12, (see Fig. 10,) which are then locked at thedesired tension by the detent 24 engaging the corresponding rack 22, andthus virtually form a single blade carrying the fold of the stomach. Thehandle is new carried around to the new angle parallel to the line :1;1/ er as near to it as the tissue will permit. 'lhe intestine is pickedup by the 'lingers or by an intestinal clamp applied in the desired lineof incision and raised up to its position against jaw 12. The thirdmember 11, which had been previously detached, is new replaced on thecentral member of the device and moved in engagement with the intestinalportion resting against jaw 12 with the result shown in Fig. 11. Astrilp of gauze-sponge is sub sequently 'placed a ong the middle bladeand the operation completed. After the anastomosis has been made thedetachable members may be removed, leaving the central portion in placeuntil the 'lield has been examined for bleeding, &c., when it may bewithdrawn. lt will thus be seen that the clamp does not have to betouched from the time it is applied until the anastomosis is complete,and being supported on the edges of the incision maintains a constanteven tension on the stomach.

Having thus described my invention, what l claim is 1. An instrument ofthe class named, eemprising a central jaw and two oppositely-disposedclamping members having a lateral movement in relation thereto.

An instrument of the class named., comprising` a central member and twooppositelydisposed clamping members pivotally and individuallydetachably mounted thereon.

3. An instrument of the class named, comprising a central rigid aw andtwo resilient, inwardly-curved blades, laterally movable in relationthereto. i

4l. In an instrument of the class named, a central member including arigid jaw and an axially-aimed shank, and two clamping members pivotallymounted upon the said shank on opposite sides thereof.

5. An instrument of the class named, com prising a central member,opposite clamping members pivotally connected therewith and means tohold the latter at any of a plurality of predetermined points.

6. A device of the class named, comprising a central member havingoppositely-exten ing, toothed arms and two opposite clamping memberspivotally mounted on the 'lirstnamed member and having detents arrangedto respectively engage the interdental sp aces in the arms. Y

7. A device of the class named, comprising a central member having arigid jaw and two clamping members pivotallyconnected therewith andhaving blades disposed on opposite sides of the aw, and elastic sleeveson the said j aw and blades.

8. An instrument of the class named com* IOS IOS

IIO

jlprising a curved central jaw and two simisimilarly-curved clampingmembers having arly-curved oppositely-disposed clamping a lateralmovement in relation thereto. members having a lateral movement inrelation thereto.

9. A clamp of the class named comprising In testimony whereof I haveaffixed my signature in presence of tWo Witnesses.

GILES F. ROOSEVELT.

three pivotally-connected members, includ- Witnesses: ing a central jawcurved in a plane parallel to G. J. ROLLANDET, the longitudinal axis ofthe pivot, and tWo- K. W. C. STUMP.

